Best Way to Get Rid of Under Eye Milia?

I get a lot of tiny little white bumps under my eyes.  Could it be milia?  How can I get rid of them?

Doctor Answers 9

Baby epiderma Inclusion cysts

Milia ( sing. milium, from the Latin millet seed) are small epidermal inclusion cysts ( sometimes erroneously called sebaceous cysts). Milia are totally, benign, tiny keratin-filled cysts. They form when the follicular orifice ( pore) is clogged. For physicians who might chance on this answer, especially those preparing for the boards, milia in the oral cavity in infants are named Epstein pearls.

Unlike blackheads ( open comedones) and whiteheads ( closed comedones), milia do not develop into acne lesions.

Primary milia in infants are the well known "milk bumps" although they have nothing to do with milk and more to do with the immaturity of the pilo-sebaceous ( hair-oil gland) unit. They can be seen later in life when the skin has been irritated, by cosmetics or the sun. They are almost invariable following deep dermabrasion ( not microdermabrasion).

There is a secondary variety which results from other skin condtitioins such as porphyria cutanea tarda,

Milia are easily treated by plucking the roof of the milium with an #11 blade and expressing the contents, either with a comedone extractor or a forceps.

There is usually no extra charge for this procedure.

To prevent further milia: consider switching cosmetics, moisturizers and/or sunscreens, and practicing sun avoidance. A Salicylic Wash and a Retinol or Retinoid are also advised. I would recommend the Salicylic Wash be used in the morning and the Retinoid at night.

Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Extraction is the simplest and most effective away to remove milia.

I agree with the posted comments by the other physicians. Milia, more commonly know as a whitehead, is a ordinary problem. It is easily treated by using a sterile small gauge needle to unroof the lesion followed by extraction of the contents. It should heal with minimal-to-no scarring. The treatment of milia should be performed by a professional!

To prevent milia from forming, I would advise a skin regimen which includes a good cleansing agent and Retinol or Retin-A products. If you are using hairspray, try to avoid this getting on the facial skin, as it can occlude the skin pores.

I hope this helps.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Salycylic Face & Body Wash for prevention

Hello MK,

I would also recommend that once you have the milia extracted you consider using a salycylic acid facial & body wash. With consistent use you can help prevent future milia from forming.

A Benzoyl Peroxide (2.5%) based lotion can also help keep your skin clear from blemishes.

Take Care,

Dr. Jafri

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Extract the milia

We see milia frequently in dermatology.  The best and simplest method is to take a tiny needle or scalpel blade and nick the milia and then use a comdone extractor to remove the contents.  It should heal beautifully and not leave any scarring. 

Take care,

Dr. Groff

William Groff, DO
San Diego Dermatologist
4.8 out of 5 stars 42 reviews

Extractions to treat, vitamin A to prevent

Simple 25-27 G needle to extract.... be careful. This is the easiest way, if needed use an extractor, then to PREVENT milia

1. Use a less occlusive moisturiser
2. Use a Vitamin A cream cautiously. 
3. Exfoliate GENTLY and occasionally. 

Dr Davin Lim
BRISBANE, Australia

Milia extraction

Unroof them with a small needle and what's inside will come out. You can either let it do it on its own, or use a comedone extractor.

Edward S. Lee, MD
Englewood Plastic Surgeon

Not too many alternatives

Milia often appear as little whiteheads that have retained skin appendages in them. The best and slowest treatment is to unroof them with a very fine needle.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Milia in eye area

These small white bumps can be taken care of by an experienced and licensed esthetician. The way it will be extracted is with with a lancet or small gage needle, there is no down time and heals beautifully within a few days.

There are many ways to resolve milia

Milia are small inclusion cysts and under the eyes are common areas for these to develop. There are many
ways to remove them, and the most common include what in dermatology we call a milia extractor, which
is sharp on one end and has what we call a comedone extractor on the other end. This is a simple
procedure that we perform almost every day in our clinics. For those that do not have a milia extractor, a
simple unroofing of the cyst with a blade or needle, followed by the use of a comedone extractor can also
be used.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.